FAUCI DIARY ARCHIVE — Saturday, March 21, 2015
https://faucisdiary.com/diary/2015-03-21

Text below is verbatim from the released PDFs, with the original line breaks.
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DIARY ENTRY — Saturday, March 21, 2015
Source: Diary Prequel, p. 435 of 2026.07.27_Diary-Prequel-.pdf
Words: 389
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Good news. Creatinine stabilized for 3 determinations in a row at
around 6 with BUN at around 115. We may get away without having to dialyze. Main
problem now is meningoencephalitis. Avi Nath (NINDS- neurologist) helping out with
neuron-management. He can only do so by history and video since he is not trained to
enter room. We cannot fully evaluate this until we lighten up his sedation, given what
happened the other night, we will do this very slowly. We have started low dose heparin
now that his platelets are coming up. CT (Cycle threshold) is now 34.5! All we need to
do is avoid PEs and bleeding. More later.

Now the Norwegians and to some extent the Canadians (much less so) are getting upset
with us since we are working with the Guineans via INSERM (Delfraissy/Levy) and the
interaction between the Liberians and Guineans to expand the vaccine RCT to Guinea,
where there are still cases. The Norwegians are trying to do a “Ring Vaccination” study
around cases similar to what was done with smallpox. However, the smallpox situation
was using a proven, highly effective vaccine. You do not “test” a vaccine in a ring
“study”. The Norwegians are concerned that our introduction of an RCT where they are
doing a Ring study would be a problem. I can understand what their concern is;
however, the elephant in the room is the fact that there study is not a study. It is a
“distribution” of an unproven product. This is the same European mentality that just
because this is a serious disease, then there is no room for research; just distribute what
you have. This same mentality led to Guinea adopting Favipiravir as standard of care
based on an open access study that claimed benefit; however, when the data was
presented at the CROI meeting, it was clear that there was no indication of efficacy since
the outbreak incidence was shifting during the study and historical controls were not
valid. God bless Cliff for sticking to his guns about RCT and good science. In this
regard, my old friend Tore Godal from Norway e-mailed me with concern about our
study since he is one of the Norwegians who are pushing the Ring study. Of note, in their
communications, nowhere are there any Guineans. Sounds like the old paternalism.